Laparoscopic distal radical gastrectomy has become one of the standard surgical procedures for early gastric cancer, with advantages such as minimal trauma and fast recovery. Standardized operation emphasizes the clearance of D2 lymph nodes in the "five regions" with the pancreas as the main anatomical landmark and safe reconstruction of the internal digestive tract. Common reconstruction methods include Billroth-I (such as Delta, triangulation), Billroth-Ⅱ, and Roux-en-Y anastomosis. In recent years, the combination of Billroth Ⅱ and Braun anastomosis has gradually gained attention due to its effective reduction of alkaline reflux gastritis, duodenal stump fistula, anastomotic inflammation, and gastroparesis syndrome, and improvement of patients’ quality of life. During the operation, attention should be paid to the tension of the anastomotic site, blood supply, and cross-over of the closure line. It is recommended to have an experienced team carry out the operation and use preoperative endoscopic submucosal injection of nano carbon to locate the tumor and improve surgical accuracy. More high-level evidence is still needed to support the long-term efficacy of oncology.